激光辅助孵化对第三天新鲜胚胎移植妊娠结局的影响

Effect of laser-assisted hatching on the outcome of the third day embryo transfer

目的:探讨反复种植失败的病人第三天新鲜胚胎行激光辅助孵化是否对妊娠结局的影响。方法:收集接受辅助生殖助孕病人共计112人(IVF/ICSI周期≥2),其中55人D3新鲜胚胎经过了激光辅助孵化(AH),57人D3新鲜胚胎未做辅助孵化(NAH)处理。结果:AH组和NAH组在年龄、获卵数、受精数、卵裂数、优质胚胎数、移植数、种植率、妊娠率之间均差异无统计学意义(P>0.05),但是AH组中移植率数值上高于NAH(21.77%vs18.87%),AH组临床妊娠率数值上也高于NAH组(32.73%vs 29.82%)。为了更好的说明激光辅助孵化对辅助生殖妊娠结局的影响,该研究还对年龄分组,比较了<35岁的病人AH组和NAH组的周期结果。同时也对≥35岁的病人AH组和NAH组周期结果对比。发现在<35岁的病人中,AH组与NAH组中年龄、获卵数、受精数、卵裂数、优质胚胎数、种植率、妊娠率差异均无统计学意义(P>0.05)。但是种植率和妊娠率数值上,AH组高于NAH组(23.40%vs 22.67%;35.71%vs 33.33%)。同样在≥35岁的病人中,AH组和NAH组中周期差异无统计学意义(P>0.05),种植率和妊娠率数值上AH组高于NAH(16.67%vs 9.68%,23.08%vs 20%)。结论:对于反复种植失败的病人,应用激光辅助孵化技术(AH)可以在数值上提高妊娠率,有利于胚胎着床。

Objective： To investigate the effect of the laser - assisted hatching on the outcome of the third day embryo transfer. Methods： A retrospective analysis of 112 IVF - ET cycles was used to compare embryo transfer after laser - AH （n = 55 ） and traditional VF - ET （ n = 57 ） . Results： There was no difference in age, numbers of ocytes, fertilization, cleavage , high quality embryos and rate of transfer, pregnancy. （P 〉 0. 05 ） between AH and NAH groups. AH transplant rate were higher than that of NAH （21.77% vs 18.87% ）, clinical pregancy rate also higher than that of NAH group （ 32. 73% vs 29. 82% ） . In order to better indicate the impact of laser -assisted hatching on pregancy outcome, the ages of women in group 1 and 2 were 〈35 years and ~〉35 years. There were no signifi- cant differences in the number of ocytes, fertilization, cleavage, high quality embryos and rate of transfer, pregnancy between the groups （ P 〉 0. 05 ） , but the value were higher in AH group than that of NAH group. Conclusion： There isnt any benefit of AH to improving implantation or pregnancy rates, but assisted hatching can increase the pregancy rate of IVF - ET in value.